Healthcare Provider Details

I. General information

NPI: 1356288740
Provider Name (Legal Business Name): TANESHA LEON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12238 COUNTRY GREENS BLVD
BOYNTON BEACH FL
33437-2037
US

IV. Provider business mailing address

12238 COUNTRY GREENS BLVD
BOYNTON BEACH FL
33437-2037
US

V. Phone/Fax

Practice location:
  • Phone: 786-499-6733
  • Fax:
Mailing address:
  • Phone: 786-499-6733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number421231
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: